1. Field of the Invention
This invention relates to a palate protective prosthesis for holding endotracheal, orotracheal or feeding tubes utilized for low birth weight neonates suffering respiratory distress or other illness requiring insertion of a tube down the trachea.
2. Summary of the Prior Art
Some infants, and particularly low birth weight neonates, often require prolonged orotracheal intubation to combat respiratory distress. A frequent complication of prolonged intubation is the formation of a palatal groove caused by pressure, and movement from the orotracheal tube against the palate and within the trachea. Ventilators may cause constant movement and vibration which also tends to cause a tube to rub on the palate, back and forth. In neonatal infants in particular, the palate has not developed sufficient hardness to resist the pressure and movement produced by the orotracheal tube over a prolonged period, and the result is the formation of a substantial permanent groove in the palate, with the resulting possible consequences of problems with dentition, speech, hearing, and middle ear disease.
Several forms of supports for orotracheal tubes have heretofore been developed for use primarily with adults. A common form of such prior art devices is characterized by the term "bite block" because generally the securement of the orotracheal tube is accomplished by a support member positioned between the patient's upper and lower teeth. The use of any such support with an infant, and particularly a neonatal infant, is obviously impractical.
An approach for protecting neonatal infants against the formation of a palatal groove is described in Volume 115, #1, pages 133-135 of the Journal of Pediatrics. In this article, the procedure followed was the formation of a maxillary impression of the palate and then the fabrication of a palate guard from a cast of the initial impression. The result was a rigid "palate plate" which, as stated in the article, required replacement of the prosthesis after four to six weeks of use, depending on the infant patient's growth rate.
This approach resulted in a significant reduction in the formation of palatal grooves due to pressure from the orotracheal tube; but, obviously involved substantial expense due to the necessity of having a skilled dentist take an impression and make an appropriate cast to form a new prothesis every four to six weeks. Moreover, the accuracy of the prothesis conformity to the palate of the infant is always in question due to the very small mouth opening within which the impression had to be made, generally using only the little finger for neonatal infants. Since the dental cast palate plate is rigid, the relatively soft infant palate may be deformed to conform to an inaccurate cast, thus creating a maldeformed palate in the infant patient.
With this background, it is readily apparent that an improved, low cost prosthesis is needed for the protection of the palates of infants requiring intubation, and not involving dental casts made from maxillary impressions taken in the mouth of the infant patient.